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Not Your Grandma’s Facial

Originally Posted: December 30, 2010

Debra Scott

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East End Laser Care, Dr. Covey. (Tara Moran)

Southampton - With doctors setting up spas in their offices and spas becoming more medically inclined, the lines between the two are often blurred.

A facial at East End Laser Care. (Tara Moran)

We recently visited a few East End's medical practitioners who have beauty in mind in search of treatments that are a step up from your average facial, yet a step down from invasive procedures. Though spa facials are feel-good, that's often just about all they are according to medical professionals. By removing the top layers of the epidermis, they make skin temporarily radiant, and with all the posh products luxuriously massaged into the skin they put you in a heavenly mood.

Medical "facials," however, focus less on nurturing and more on making dramatic changes, sometimes with a bit of discomfort. After a serious medical facial, which you can get on your lunch hour, you'll be deflecting the compliments of admirers who won't have a clue that the big guns were brought in.

 • Kenneth Mark, MD, FAAD
Located at 365 County Road 39A, Southampton,631-283-0002, www.kennethmarkmd.com
Perhaps best known for Mohs micrographic surgery, a specialized technique for removing skin cancer, the Cosmetic Dermatology Center of the Hamptons, with offices in both East Hampton and Southampton, also offers an array of facial treatments. Dermatologist Kenneth Mark employs esthetician Tracy Kociszewski to perform the facials.

Esthetician Tracy Kociszewski of the Cosmetic Dermatology Center of the Hamptons. (Debra Scott)

Tracy begins with a manual exfoliation called dermaplaning during which a blade, similar to a scalpel but with a smooth end, is held at a 45 degree angle and stroked along the facial surface to remove the outer layers of dead skin cells. The hairs come off too (as dirt and oil accumulate in the peach fuzz), so it's as close to a shave as a woman will ever get (Think: barber shave), thus making the skin feel smoother than its ever felt. But that's not the whole point. The resulting skin canvas is now ready for the next step. (Not to worry, the hair grows back as soft as ever). Next Tracy applies a high-strength (30 percent) Lactic Acid Peel to remove more epidermal layers. Lactic acid is derived from sour milk. Cleopatra, known for taking milk baths, was no fool. As the acid penetrates, it tingles and burns and may even result in skin flaking. But it's all good. The more skin removed, the more will grow back fresh and new. The final stage is the application of a toner and hydrating cream from Dr Mark's anti-aging skincare line. The products are comprised of vitamins, peptides, green tea, and eight antioxidants, including astaxanthin which he claims is a thousand times more potent than Vitamin E and works to reduce melanin production and optimize the skin's defenses. The Ritz Carlton Club in Aspen uses his products for their signature facial - $175 for both treatments.

Ultherapy Before.

 • Barry M. Weintraub, MD, FACS
Near the Ross School, East Hampton, 631-324-4800, www.drbarryweintraub.com
Plastic surgeon Barry Weintraub has offices in the city and in his East Hampton home where he conducts non-surgical procedures in a chair set before a fireplace. Photos don't lie, and Weintraub first takes a series of close-ups so that he can point out reality to potentially disbelieving patients. He assesses areas in need of improvement in order to choose from several approaches in his bag of tricks. For the typical patient with a few frown lines (horizontal creases on forehead), the dreaded '11s' (those vertical lines between the eyes), and crow's feet, he applies Botox® (which he says has been used medically since 1948), a neuro-muscular paralytic that "freezes" the muscles responsible for "negative" expression lines. ($400 per area).

First he numbs the flesh with a triple numbing cream of his own design containing benzocaine, lidocaine, and tetracaine to dull the stinging sensation. Using a fine gauge Japanese needle, he pricks forehead, the bridge of the nose, and eye squint lines to inject the serum. He avoids the area above the brow bow to keep the muscles intact so they are able to pull the brow up for a "pretty little lift." It takes a few days for the results - a smooth as marble forehead, softened crow's feet - to develop. For lips, which thin as we age due to decreasing collagen, he injects a "filler" comprised of hyaluronic acid (trade name Restylane) ($1.250), a fluid made in our bodies, to plump them up. Eminently conservative, he injects only enough to give them an immediate natural slight bee-stung look, never risking the fish lips that have given this simple procedure a bad rap. Move over Angelina! Both treatments last in excess of six months. Other treatments he performs by his hearth include laser resurfacing and deep peels. Formerly on staff at Cedars-Sinai Medical Center, a mecca of beautification in Los Angeles, he witnessed the excesses of celebrities who don't know when to say 'no' to plastic surgery. "If you don't see an issue, don't touch," he advises. If you do, he has many simple treatments involving neither nip nor tuck up his sleeve.

Ultherapy After.

 • Donna Graziano, Licensed Medical Esthetician
Director of Patient Development, Dr. Philip Miller, 60 East 56th, New York City, 212-750-7100, www.drphilipmiller.com, Hamptons house calls.

Donna Graziano, who works in the NYC offices of plastic surgeon Philip Miller, makes Hamptons house calls from spring through summer (but is booking now) toting powerful machines to blast skin back to its youthful firmness. While her clients often organize parties around her chemical peels and Botox injections, her latest anti-aging weapon is Ultherapy ($2,500-$5,000), the Next Big Thing in non-surgical facelifts featured on the Dr. Oz Show in December. Though Ultherapy has been wowing women in Europe for several years (and is currently performed in 40 countries), it only recently arrived in the U.S. Originally used medically to ablate liver tumors, it has been developed into a 30-minute procedure that uses ultrasound to tighten skin of the face and neck.

While lasers and pulsed light travel from the outside in, ultrasound goes deep inside the connective tissue, 4.5 mm to be exact, without damaging the skin. There it "heats the deep fibro-muscular support network of collagen fibers," according to Melissa Dodds, Clinical Applications Specialist at Ulthera, Inc. In other words, it implodes tired old collagen so that the body's natural repair process will restore its "memory." Though there are immediate subtle results, it takes 90 days for collagen to renew. The effect is meant to last up to 18 months. "It basically shrink wraps the outer surface of your face," says Donna. Patients report that it works "miracles" to remove sagging jowls and redefine the jaw line into a knifelike edge. Alas, the procedure is not pain-free and pain medication is often recommended. For clients sensitive to pain, Donna can achieve similar results with Pelleve™ ($500-$3,000) which uses advanced radio wave technology to increase collagen production, remove mild to moderate facial wrinkles and tighten saggy skin. There is only a relaxing heat sensation under the skin.

Plastic surgeon Barry M. Weintraub performs non-invasive treatments at his East Hampton office. (Debra Scott)

 • Alexander Covey, MD
445 Main Street, Center Moriches, 631-878-9200, www.drcovey.com
Surgical and Medical Director of East End Laser Care, Dr. Alexander Covey has performed non-surgical cosmetic procedures since 1988 in his Manhattan, Center Moriches and Southampton offices. His many treatments include Thermage™, a tightening procedure for both face and body; VolumaLift™ (also known as the Liquid Facelift); the Fraxel re:store™ Laser Treatment for skin resurfacing and skin renewal; and Smartlipo MPX™ for fat removal and body sculpting.

The starter "facial" recommended by Covey is medical grade microdermabrasion ($150). Using crystals as exfoliants, the procedure stimulates collagen "networking." Though microdermabrasion can be had at spas, Dr. Covey says that the medical grade version goes much deeper, to the midrecticular dermis to be precise, thus is much more effective. Afterwards, skin looks and feels as bright and dewy as a skin care ad. Covey recommends a series of six and says that results average a 50 to 75 percent improvement in elasticity. These treatments can alleviate a wide variety of imperfections. Next stop: surgery.

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Guest (Xavier Smith) from Utah says::
This seems so smart. To have a doctor's office that seems like a spa would make the experience that much more enjoyable. This is especially true since Doctor's offices make me nervous. Xavier Smith
Apr 30, 2014 8:16 pm


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